I have been advised of and understand that treatment of dental conditions requiring root canal treatment involves certain risks and possible unsuccessful results including the possibility of failure. Even when care and diligence are exercised in the treatment of conditions requiring root canal, there are no promises or guarantees of anticipated results. I agree to assume the risks associated with root canal treatment, which include but are not limited to the following:
- Possibility of separated instruments which may prevent successful treatment
- Perforations (accidental and/or openings) of the crown or root of the tooth
- Identifications of crown or root fracture during or after treatment
- Damage to existing crowns, bridges, or other appliances
- Root canal filling material which extends beyond the end of the root
- Blocked root canals may prevent successful treatment
- Loss of tooth structure/weakening of tooth
- Post-operative pain, swelling, and /or infection
- A 5-15% chance of failure
On rare occasions there are secondary canals that are not found and may require a referral to a specialist even after the root canal is completed by the doctor. The benefits of a successful root canal treatment include the relief of pain and the ability to retain the tooth's comfort and function.
I understand that root canal treatment weakens the crown of the tooth. The dentist has explained to me the need for a crown which adequately protects the tooth after the root canal treatment has been completed. I understand that no guarantee of success has been or can be given. All my questions have been answered by the dentist, and I fully understand all the above statements contained in this consent form.